Maya - Vesicoureteral Reflux (VUR)

It was that time of year again. We had to take Maya in for testing on Wednesday. First they do a sonogram of her kidneys to make sure they are growing properly and that there is not any scarring. Maya was very sweet and cooperative during the sonogram. She was relaxed and happy that it didn't hurt at all. Then the bad part... VCUG. It is not a pleasant process. They have to fill her bladder with a special dye thru a catheter while the entire time she is laying on a table. Then they take X-rays. The older she gets the harder this procedure becomes because she is fully awake and aware of everything. Also, she has an impeccable memory.

Friday we had the appointment with her Urologist. He confirmed that her VUR condition has not improved at all during the last year. This was, of course, very disappointing news. She still has VUR grade 2 on her left side. Last year she had outgrown the VUR on her right side. Her kidneys look normal, so that was good.

We have some options. (1) We can do what we have been doing for another year, which is giving her an antibiotic everyday to prevent infection. (2) Since she is now getting potty trained, we have the option of taking her off the medicine and carefully watching for signs of an infection. If she DID get an infection we would put her back on medicine and probably then need to decide on one of the 2 surgical options which I will explain below. If she DID NOT get any infections in say a year, we would just no longer "treat" the VUR, but just yearly check her kidneys. (3) First surgical option is where they would cut her open much like a C-Section and go in and fix both of her ureters. This option is 98% effective. She would be in the hospital for 24-48 hours and then recover at home for 7-10 days after that. That is very aggressive and I really don't feel like Maya is ready for this. (4) The other surgical option is an endoscopic treatment, it is called Deflux. It is an outpatient procedure that is done quickly and she would be, as the doctor describes it, "playing soccer that night." It is 85% effective. There is much more about this procedure and VUR in general at http://www.deflux.com/ for those of you who might be interested.

I think I am leaning toward medicating Maya for a few more weeks until her potty training is more solid. (She is doing GREAT though!) Then, I'd like to see how she does. IF she got an infection, I would choose the deflux. I did read that it is most effective in those children who have unilateral VUR (Maya does) and for grades 2-4 (Maya is currently grade 2).

Mostly I wish to never have to have her go thru the VCUG again, but I just don't know that that is possible. Dr. did say next time we could give her some gas at least during the insertion of the catheter... that would help some.

We pray she outgrows this condition, but since she made no progress this year, I just don't know that it is going to happen that way.

Interesting too, I read in the pamphlet for deflux that this is a lot LESS COMMON than I thought. It says that only 1% of children in the WORLD have VUR!